Comparison of Minimally Invasive Transforaminal and Anterolateral Lumbar Interbody Fusion for Treatment of Low-grade Lumbar Spondylolisthesis.

Abstract

This was a retrospective cohort study. The aim was to compare the clinical outcomes, radiographic parameters and perioperative complications of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and anterolateral lumbar interbody fusion (ALLIF) for the treatment of low-grade lumbar spondylolisthesis. Both MIS-TLIF and ALLIF are minimally invasive surgical methods for the treatment of lumbar degenerative diseases. However, few studies have compared the results of MIS-TLIF and ALLIF for the treatment of low-grade lumbar spondylolisthesis. A total of 112 patients with low-grade lumbar spondylolisthesis were divided as MIS-TLIF group (n=59, mean age 61.7 y) or ALLIF group (n=53, mean age 60.1 y) according to the treatment method. The operative time, intraoperative blood loss, and length of hospital stay were recorded. Besides, clinical outcomes were evaluated by visual analog scale and Oswestry disability index score. Radiographic parameters were assessed by disc height, lumbar lordosis, segmental lordosis, and fusion rate. ALLIF significantly reduced operative time, intraoperative blood loss, and length of hospital stay compared with MIS-TLIF. Moreover, ALLIF was superior to MIS-TLIF in the early postoperative relief of back pain and recovery of lumbar function. However, there were no significant differences in the clinical outcomes at final follow-up between the 2 groups. The amount of change between preoperative and postoperative disc height, lumbar lordosis and segmental lordosis in ALLIF group were significantly higher than those in MIS-TLIF group (P<0.05). However, there were no significant differences in fusion rate and incidence of complications between the 2 groups. This study indicated that the final follow-up clinical outcomes, complication rate of ALLIF were similar to MIS-TLIF for the treatment of low-grade lumbar spondylolisthesis. However, ALLIF showed advantages in less surgical trauma, faster recovery, early postoperative relief of back pain, and radiographic parameters improvement.